Factoring in health care inflation, age, and increased cost-shifting, the report found that those costs are continuing to rise—bad news for retirees and those still on the job who are trying to save enough to cover their expenses in retirement.

The report found that the average healthy 65-year-old couple retiring this year is projected to spend $288,400 in today’s dollars on lifetime Medicare Parts B, D, and supplemental insurance (Plan F) premiums.

If that’s not a gloomy enough picture, add in dental, hearing, vision, and all other out-of-pocket expenses are included—then the total retirement health care bill rises to $377,412.

For retirees hoping to rely on Social Security for a significant portion of their income, they’d probably better think again.

A 66-year-old couple retiring this year, the report found, will need 57 percent of their Social Security to cover total health care costs.

A 55-year-old couple retiring in 10 years will require 88 percent, and a 45-year-old couple, 116 percent.

The calculations to arrive at these figures, it said, are based on the Social Security trustees’ projections of a 3.1 percent cost-of-living adjustment (COLA) in 2017 and 2.7 percent thereafter.

The picture is so gloomy that some people, according to Ron Mastrogiovanni, founder and CEO of HealthView Services, could eventually see their medical expenses actually exceed their Social Security benefits.

Inflation in health care costs is one factor, with overall costs projected to have increased by 7.3 percent between 2015 and 2016, driven in part by a 16.1 percent increase in Medicare Part B premiums over the same period.

Over the next 20 years, HealthView projects a more modest average annual inflation rate of 5.1 percent for retirement health care expenses, which it said is consistent with forecasts from the Centers for Medicare and Medicaid. The Centers expect at least eight years of health care inflation between 5 percent and 7 percent.

And women will suffer disproportionately. A 30-year-old female retiring at 65 can expect to pay $548,098 in today’s dollars, the report said, in total lifetime retirement health care expenses; that’s $118,632 more than a male of the same age, based on life expectancies of 91 and 87, respectively.